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Pediatric primary care

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https://www.readbyqxmd.com/read/28922571/interprofessional-oral-health-initiative-in-a-nondental-american-indian-setting
#1
Kate L Murphy, Laura S Larsson
BACKGROUND AND PURPOSE: Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. METHODS: The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral...
September 18, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#2
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921890/phase-ii-study-of-dabigatran-in-children-with-venous-thrombosis-pharmacokinetics-safety-and-tolerabilty
#3
J M L Halton, M Albisetti, B Biss, L Bomgaars, M Brueckmann, S Gropper, R Harper, F Huang, M Luciani, H Maas, I Tartakovsky, L G Mitchell
BACKGROUND: The current standard-of-care treatments for pediatric venous thromboembolism (VTE) have limitations. Dabigatran etexilate (DE), a direct thrombin inhibitor, may offer an alternative therapeutic option. OBJECTIVES: To assess the pharmacokinetics (PK), pharmacodynamics (PD), safety and tolerability of DE oral liquid formulation (OLF) in pediatric patients with VTE. PATIENTS/METHODS: Patients who had completed planned treatment with low-molecular-weight heparin or oral anticoagulants for VTE were enrolled in two age groups (2-<12 and 1-<2 years) and received DE OLF based on an age- and weight-adjusted nomogram...
September 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#4
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917392/description-of-a-multi-university-education-and-collaborative-care-child-psychiatry-access-program-new-york-state-s-cap-pc
#5
D L Kaye, V Fornari, M Scharf, W Fremont, R Zuckerbrot, C Foley, T Hargrave, B A Smith, J Wallace, G Blakeslee, J Petras, S Sengupta, J Singarayer, A Cogswell, I Bhatia, P Jensen
OBJECTIVE: Although, child mental health problems are widespread, few get adequate treatment, and there is a severe shortage of child psychiatrists. To address this public health need many states have adopted collaborative care programs to assist primary care to better assess and manage pediatric mental health concerns. This report adds to the small literature on collaborative care programs and describes one large program that covers most of New York state. PROGRAM DESCRIPTION: CAP PC, a component program of New York State's Office of Mental Health (OMH) Project TEACH, has provided education and consultation support to primary care providers covering most of New York state since 2010...
September 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28916453/making-the-legal-and-ethical-case-for-universal-screening-for-postpartum-mood-and-anxiety-disorders-in-pediatric-primary-care
#6
Amy Lewis Gilbert, Casey Balio, Nerissa S Bauer
Postpartum depression (PPD), part of a larger spectrum of perinatal mood and anxiety disorders, affects up to 15% of women following the birth of an infant. Fathers may also be affected. PPD not only affects caregivers, but also impacts infants through mechanisms such as inadequate caregiver-infant interactions and non-adherence to safety practices. The negative impact on infants may extend across the life course through adulthood. This article seeks to move the needle toward universal screening for PPD using validated tools in pediatric primary care settings for new caregivers by making the legal and ethical case for this course of action in a manner that is both compelling and accessible for clinicians...
September 12, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28916250/successful-integration-of-pediatrics-into-state-health-care-reform-efforts
#7
Judith S Shaw, Susan E Varni, Elizabeth Cheng Tolmie, Mary Kate Mohlman, Valerie S Harder
Health care reform in Vermont promotes patient-centered medical homes (PCMH) and multi-disciplinary community health teams to support population health. This qualitative study describes the expansion of Vermont's health care reform efforts, initially focused on adult primary care, to pediatrics through interviews with project managers and facilitators, CHT members, pediatric practitioners and care coordinators, and community-based providers. Analyses used grounded theory, identifying themes confirmed by repeat occurrence across respondents...
September 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28916249/diagnostic-errors-impact-of-an-educational-intervention-on-pediatric-primary-care
#8
Julianne Nemes Walsh, Margaret Knight, A James Lee
INTRODUCTION: The purpose of our study was to determine the impact of an educational program on a provider's knowledge related to diagnostic errors and diagnostic reasoning strategies. METHODS: A quasi-experimental interventional study with a multimedia approach, case study discussion, and trigger-generated medical record review at two time points was conducted. Measurement tools included a test developed by the National Patient Safety Foundation, Reducing Diagnostic Errors: Strategies for Solutions Quiz, additional diagnostic reasoning questions, and a trigger-generated process to analyze medical records...
September 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28916019/the-basic-science-of-behavior-change-and-its-application-to-pediatric-providers
#9
REVIEW
Allison R Love, Peter S Jensen, Lisa Khan, Tiffany West Brandt, James Jaccard
Pediatric primary care providers (PPCPs) are increasingly expected to know how to assess, diagnose, and treat a wide range of mental health problems in children and adolescents. For many PPCPs, this means learning and performing new practice behaviors that were not taught in their residency training. Typical continuing education approaches to engage PPCPs in new practices have not yielded the desired changes in provider behavior. This article summarizes behavior change principles identified through basic behavior science, adult education, and communication research, and discusses their application to a patient-centered pediatric primary care mental health curriculum...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916016/comparing-two-models-of-integrated-behavioral-health-programs-in-pediatric-primary-care
#10
REVIEW
Miguelina Germán, Michael L Rinke, Brittany A Gurney, Rachel S Gross, Diane E Bloomfield, Lauren A Haliczer, Silvie Colman, Andrew D Racine, Rahil D Briggs
This study examined how to design, staff, and evaluate the feasibility of 2 different models of integrated behavioral health programs in pediatric primary care across primary care sites in the Bronx, NY. Results suggest that the Behavioral Health Integration Program model of pediatric integrated care is feasible and that hiring behavioral health staff with specific training in pediatric, evidence-informed behavioral health treatments may be a critical variable in increasing outcomes such as referral rates, self-reported competency, and satisfaction...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916010/competencies-and-training-guidelines-for-behavioral-health-providers-in-pediatric-primary-care
#11
REVIEW
Wanjiku F M Njoroge, Ariel A Williamson, Jennifer A Mautone, Paul M Robins, Tami D Benton
This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Children's Hospital of Philadelphia, is described...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916007/from-theory-to-action-children-s-community-pediatrics-behavioral-health-system
#12
REVIEW
Abigail Schlesinger, Jacquelyn M Collura, Emily Harris, Joanna Quigley
Integrated health care models attempt to cross the barrier between behavioral and medical worlds in order to improve access to quality care that meets the needs of the whole patient. Unfortunately, the integration of behavioral health and physical health providers in one space is not enough to actually promote integration. There are many models for promoting integration and collaboration within the primary care context. This article uses the experience of the Children's Community Pediatrics Behavioral Health Services system to highlight components of collaboration that should be considered in order to successfully integrate behavioral health within a medical home...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916006/using-effective-public-private-collaboration-to-advance-integrated-care
#13
REVIEW
Lee S Beers, Leandra Godoy, Matthew G Biel
Integrated mental health services within health care settings have many benefits; however, several key barriers pose challenges to fully implemented and coordinated care. Collaborative, multistakeholder efforts, such as health networks, have the potential to overcome prevalent obstacles and to accelerate the dissemination of innovative clinical strategies. In addition to engaging clinical experts, efforts should also include the perspectives of families and communities, a grounding in data and evaluation, and a focus on policy and advocacy...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916005/massachusetts-child-psychiatry-access-project-2-0-a-case-study-in-child-psychiatry-access-program-redesign
#14
REVIEW
Barry D Sarvet, Marcy Ravech, John H Straus
The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#15
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28914343/image-guided-percutaneous-removal-of-ballistic-foreign-bodies-secondary-to-air-gun-injuries
#16
Jacob L Rothermund, Andrew J Rabe, Nicholas A Zumberge, James W Murakami, Patrick S Warren, Mark J Hogan
BACKGROUND: Ballistic injuries with retained foreign bodies from air guns is a relatively common problem, particularly in children and adolescents. If not removed in a timely fashion, the foreign bodies can result in complications, including pain and infection. Diagnostic methods to identify the presence of the foreign body run the entire gamut of radiology, particularly radiography, ultrasound (US) and computed tomography (CT). Removal of the foreign bodies can be performed by primary care, emergency, surgical, and radiologic clinicians, with or without imaging guidance...
September 15, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28914239/road-blocks-perceived-by-the-dentists-toward-the-treatment-of-early-childhood-caries-in-chennai-city-a-cross-sectional-study
#17
Habibkhan Faizunisa, Preetha Elizabeth Chaly, Mohammed Junaid, Selvaperumal Vaishnavi, J E Nijesh, Mohammed Musthafa
BACKGROUND: The problem of early childhood caries remains a worldwide public concern, as most of the caries remains untreated. Despite advances in dental care, most children fail to benefit from oral health-care services not only due to differences in attitudes in parents but also in oral health-care providers. OBJECTIVES: The objective of the study is to determine the road blocks perceived by the dentist in Chennai, toward the treatment of early childhood caries...
October 2017: Journal of the Indian Society of Pedodontics and Preventive Dentistry
https://www.readbyqxmd.com/read/28912056/revisiting-unplanned-extubation-in-the-pediatric-intensive-care-unit-what-s-new
#18
REVIEW
Paulo Sérgio Lucas da Silva, Daniela Farah, Marcelo Cunio Machado Fonseca
In 2010, recommendations for preventing unplanned extubations (UEs) in pediatric patients were published based on a literature review. Since then, there have been an increasing number of publications related to UE focusing on children. If the introduction of care bundles and larger body of evidence on UE had impact on UE occurrence, this would have important implications on clinical practice. We searched for relevant publications published between Jan 1, 2010 and Jun 30, 2016 in the MEDLINE, EMBASE, and Cochrane systems...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28904822/a-parental-perspective-concerning-barriers-to-care-for-neural-tube-defects-in-china
#19
Andrew Campion, Clement Lee, Nan Bao, Jorge Lazareff
BACKGROUND: The People's Republic of China (PRC) has the highest incidence of neural tube defects (NTDs) in the world. NTDs remain a significant contributor to the global burden of disease amendable to surgical care; however, no studies to date have evaluated the patients' perspective regarding perceived barriers to care. METHODS: The study was conducted at the Shanghai Children's Medical Center (SCMC) between 6/11/2014 and 7/17/2014. Surveys were administered to families presenting to the clinic of the SCMC director for Pediatric Neurosurgery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28902088/obesity-increases-risk-of-loss-of-reduction-after-casting-for-diaphyseal-fractures-of-the-radius-and-ulna-in-children-an-observational-cohort-study
#20
Christopher J DeFrancesco, Benjamin H Rogers, Apurva S Shah
OBJECTIVES: To determine if high body mass index (BMI) increases the risk of loss of reduction (LOR) following closed reduction and casting for displaced concomitant fractures of the radial and ulnar shafts in pediatric patients. DESIGN: Retrospective cohort study SETTING:: A single tertiary care, urban children's hospital PATIENTS/PARTICIPANTS:: Pediatric patients aged 2-18 years with closed, displaced, concomitant diaphyseal fractures of the radius and ulna (AO/OTA 22-A3) who underwent closed reduction and casting at the study site...
August 26, 2017: Journal of Orthopaedic Trauma
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